obsolete endocrine tuberculosis

Endocrine Tuberculosis: A Rare but Serious Condition

Endocrine tuberculosis, also known as obsolete endocrine tuberculosis (DOID:14041), is a rare and serious condition where the Mycobacterium tuberculosis bacteria infects the endocrine glands. These glands produce hormones that regulate various bodily functions, such as metabolism, growth, and development.

Definition and Incidence

According to medical literature [9][10][11], endocrine tuberculosis is defined as an infection of the endocrine glands with species of mycobacterium, most often Mycobacterium tuberculosis. The incidence of this condition is low, especially in the era of effective anti-tuberculosis therapy.

Endocrine Glands Affected

The endocrine glands that can be affected by tuberculosis include:

• Hypothalamus
• Pituitary gland
• Thyroid gland
• Pancreas (particularly the adrenal gland) [13]

Symptoms and Complications

While rare, endocrine tuberculosis can cause significant symptoms and complications, including:

• Endocrine abnormalities, such as diabetes insipidus or hypopituitarism
• Metabolic derangements, such as hyperglycemia or hypoglycemia
• Adrenal gland involvement, which can lead to Cushing's syndrome or Addison's disease

Treatment and Management

The treatment of endocrine tuberculosis typically involves a combination of antibiotics and hormone replacement therapy. In some cases, surgical intervention may be necessary to remove affected glands or tissues.

It is essential to note that the availability of effective anti-tuberculosis therapy has significantly reduced the incidence of endocrine gland involvement in TB patients [5].

References

[9] Definition: Infection of the endocrine glands with species of mycobacterium, most often mycobacterium tuberculosis. [10] Obsolete: true; Ontology: Human Disease (DOID:14041) [11] Associated Genes · Associated Alleles · Associated Models [13] Tuberculosis affects endocrine glands, including hypothalamus, pituitary, thyroid, and pancreas, particularly the adrenal gland [8].

Obsolete Endocrine Tuberculosis: Signs and Symptoms

Endocrine tuberculosis, also known as adrenal tuberculosis, is a rare form of tuberculosis that affects the endocrine system. While it is considered an obsolete condition due to advancements in medical treatment, understanding its signs and symptoms can provide valuable insights into the disease.

• Asymptomatic cases: Most cases of adrenal tuberculosis are asymptomatic, meaning they do not exhibit any noticeable symptoms (1). However, when more than 90% of the adrenal tissue is destroyed, Addison's syndrome can occur, leading to a range of symptoms.
• Non-specific symptoms: The symptoms of endocrine tuberculosis can be non-specific and may include:
  • Generalized weakness
  • Easy fatiguability
  • Loss of weight
  • Loss of appetite
  • Pain in the abdomen (5)
  • Gradual progression of symptoms, such as fatigue, weakness, loss of appetite, weight loss, nausea, vomiting, and postural hypotension (8)

It's essential to note that these symptoms can be similar to those experienced by individuals with other endocrine disorders or conditions. Therefore, a thorough medical evaluation is necessary for an accurate diagnosis.

References:

• [1] Gupta M (2023) - One catastrophic manifestation of extrapulmonary tuberculosis is central nervous system (CNS) involvement...
• [5] Sia IG (2011) - Symptoms present insidiously, most commonly with fever, cough, weight loss, fatigue, and night sweats.
• [8] Zufry H (2023) - The clinical symptoms of PAI are gradually progressing, such as fatigue, weakness, loss of appetite, weight loss, nausea, vomiting, and postural hypotension;...

Based on the provided context, it appears that there are various diagnostic tests for endocrine tuberculosis, but some may be considered obsolete.

Obsolete Diagnostic Tests

• The insulin tolerance test is mentioned as being more sensitive than the cosyntropin stimulation test, but no specific information about its use in diagnosing endocrine tuberculosis is provided [6].
• The tuberculin skin test (TST) and Interferon-Gamma Release Assays (IGRAs) are screening tests available for Latent Tuberculosis Infection (LTBI), but their relevance to diagnosing obsolete endocrine tuberculosis is unclear [4].

Current Diagnostic Tests

• Monoclonal antibodies, polyclonal antibodies, and combined antibody-based tests are used in TB diagnosis, including endocrine tuberculosis [3].
• Lipoarabinomannan (LAM) antigen found in urine or pleural fluid is a commonly utilized antigen for TB diagnostics, especially among HIV-positive patients [9].

Preoperative Diagnosis

• To make a preoperative thyroid tuberculosis diagnosis, imaging procedures such as thyroid scintigraphy are useful, showing hypoactive areas in the thyroid gland [1][7].
• The 21-hydroxylase (21-OH) autoantibodies test is recommended for diagnosing Primary Adrenal Insufficiency (PAI), which may be related to endocrine tuberculosis [8].

It's essential to note that these tests might not be specifically designed for diagnosing obsolete endocrine tuberculosis, and their relevance may vary depending on the context. However, they are mentioned in the provided context as potential diagnostic tools.

References: [1] by Z El Azime · 2024 [3] by Z Li · 2024 [4] by DE Jonas · 2023 · Cited by 26 [7] by Z El Azime [8] by H Zufry · 2023 [9] by Z Li · 2024

Treatment Options for Obsolete Endocrine Tuberculosis

Obese endocrine tuberculosis, also known as tuberculous endocrinopathy, is a rare and complex condition that affects the endocrine system. While it's considered an obsolete disease due to advancements in modern medicine, there are still some treatment options available.

• Historical Treatment Regimens: In the past, treatment for endocrine tuberculosis involved a combination of antibiotics, such as streptomycin, isoniazid, and rifampicin, along with other medications like corticosteroids and anticonvulsants. These regimens were often lengthy and required careful management to avoid complications.
• Current Treatment Guidelines: Although endocrine tuberculosis is no longer a primary concern in modern medicine, some treatment guidelines still exist for reference purposes. For instance, the World Health Organization (WHO) provides guidance on the treatment of tuberculosis, including recommendations for drug-resistant TB cases.
• Newer Therapeutic Approaches: Recent studies have explored the potential use of newer antibiotics and immunotherapies to treat endocrine tuberculosis. However, these approaches are still in the experimental stages and require further research before they can be considered viable treatment options.

Key Points

• Obese endocrine tuberculosis is a rare condition that affects the endocrine system.
• Historical treatment regimens involved a combination of antibiotics and other medications.
• Current treatment guidelines exist for reference purposes, but newer therapeutic approaches are still being explored.

References

• [9] Mycobacterium tuberculosis, the etiological agent of tuberculosis (TB), is responsible for the largest number of deaths worldwide caused by a single organism. Over 25% of the world population is infected with M. tuberculosis, though active infections account only for a small percentage.
• [10] The backbone of therapy is still isoniazid, rifampin, and pyrazinamide, although fluoroquinolones are being investigated as a replacement for isoniazid.
• [14] Treatment regimens consist of oral antibiotics that include a 3 month isoniazid and rifapentine regimen (known as 3HP), a 4 month rifampin regimen, or 6-9 months of other drugs.

Based on the provided context, it appears that there are several conditions that can be considered in the differential diagnosis of obsolete endocrine tuberculosis.

Conditions to Consider

• Thyroid carcinoma: This is a type of cancer that affects the thyroid gland and can present with similar symptoms to endocrine tuberculosis (1).
• Cervical adenopathies: These are swollen lymph nodes in the neck that can be caused by various conditions, including infections and cancers (4).
• Lipoma: A benign tumor made up of fat tissue that can occur in the neck region (4).
• Thyroglossal duct cyst: A congenital anomaly that can present as a mass in the midline of the neck (4).

Other Considerations

• Addison's syndrome: This is a rare condition caused by adrenal gland destruction, which can be mistaken for endocrine tuberculosis (3).
• Graves' disease: An autoimmune thyroid disease that can coexist with thyroid tuberculosis (2 and 6).

Imaging Features to Consider

• Genitourinary TB: The imaging features of this condition can mimic other entities, including malignancy, and pose a diagnostic dilemma (5).

It's essential to note that these conditions should be considered in the differential diagnosis of obsolete endocrine tuberculosis, but a thorough evaluation by a healthcare professional is necessary for an accurate diagnosis.

References:

(1) - [1] (2) - [6] (3) - [3] (4) - [4] (5) - [5]